CCM Practice Exam Flashcards
The grief reaction and psychological exhaustion experienced by the health care professional that occurs during helping interactions is called
empathy fatigue
After assessment, the planning component of case management includes
developing realistic and measureable goals.
According to the Americans with Disabilities Act (ADA), an “otherwise qualified” person is one who is:
capable of performing essential job functions with or without accommodations.
Research indicates that the best treatment for depression is a combination of:
psychotropic medication and psychotherapy
Managed care plans that reimburse specialty physicians under capitation pay providers based on:
a fixed payment per member per month.
Managed care plans that reimburse specialty physicians under capitation pay providers based on:
a fixed payment per member per month.
Preferred Provider Organizations (PPOs) are formed to:
contract with providers for reimbursement discounts.
The medical home model is a:
source of primary health care
In somatoform disorders, there are:
physical symptoms for which no organic cause can be found.
Disorientation in an elderly client without obvious organic cause could be considered a symptom of:
overmedication.
Health maintenance organizations (HMOs) are healthcare systems that are:
responsible for financing and delivery of health services to an enrolled population.
In addressing the issue of elder abuse, it is crucial for the case manager to:
have the client removed from the place of residence where the abuse is occurring.
confront the abuser and refer him/her to appropriate help.
report the abuse to law enforcement.
evaluate for potential risk and intervene to reduce or eliminate the risk.
evaluate for potential risk and intervene to reduce or eliminate the risk.
A principle of life care planning is:
collecting documentation from doctors.
providing for needed quality of care.
receiving referrals from attorneys.
obtaining clients
’
tax documents.
providing for needed quality of care.
Which of the following assessment tools would be most useful when evaluating whether a geriatric client will need additional care giving support?
Barium swallow study.
Verbal Descriptor Model.
Activities of Daily Living Scale.
Braden Scale.
Activities of Daily Living Scale.
In the presence of language barriers, the case manager should:
employ a professional interpreter.
utilize pictures or diagrams.
transfer the case to a bilingual case manager.
use family members as interpreters.
employ a professional interpreter
The overall goal of negotiation is to:
obtain a quality product.
gain acceptance of a rate change.
achieve a win/win scenario for all parties involved.
get the lowest price.
achieve a win/win scenario for all parties involved.
In order for a child to receive an assistive technology device through an
Individual Education Plan (IEP), the device must be:
recommended by the treating physician.
educationally necessary.
federally defined as an assistive device.
unaffordable for the family.
educationally necessary
A network of services focused on outreach, advocacy, and helping individuals live as independently as possible is a(n):
work adjustment program.
community support program.
disability management program.
inpatient rehabilitation program.
community support program
Health maintenance organizations (HMOs) are healthcare systems that are:
responsible for developing evidence-based health research.
used to help injured workers receive care for their injuries.
jointly owned and operated by hospitals and their affiliated physicians.
responsible for financing and delivery of health services to an enrolled population.
responsible for financing and delivery of health services to an enrolled population.
One goal of effective disease management is to:
diagnose chronic conditions.
promote workplace safety.
promote physician-directed programs.
prevent exacerbations and complications.
Prevent exacerbations
The first step in the problem-solving process is to:
define the problem.
establish goals.
identify potential problems.
specify the consequences.
define the problem
The preferred level of care for a patient who requires intravenous antibiotics administered four times a day for a two week period and cannot afford nor safely manage this care alone at home is:
a skilled nursing facility.
an acute care hospital.
an assisted living facility.
home care with a visiting nurse.
a skilled nursing facility
An unexpected occurrence not related to the natural course of illness that results in death, serious physical or psychological injury, or permanent loss of function is called a:
sentinel event.
variance.
complication.
catastrophic event.
sentinel event
A dimension to the health belief model affecting decision-making and motivation is:
perceived opportunities.
perceived benefits.
response to symptoms.
response to medical regimens.
perceived benefits
The case manager’s documentation of patient and family teaching based on the patient’s condition and needs should include:
problem-oriented goals.
expected length of service.
potential treatment risks.
cost of service.
problem-oriented goals.
In case management, the process of creating formal written statements of goals and responsibilities with the client is called:
leadership.
contracting.
negotiation.
motivation.
contracting
A primary component of effective negotiating is:
having an agenda.
knowing the answer.
maintaining eye contact.
practicing active listening.
practicing active listening.
A major reason for nursing home placement of an Alzheimer’s patient is the:
lack of available financial resources.
ability to perform activities of daily living.
lack of available community resources.
lack of a willing caregiver.
lack of a willing caregiver
The benefit plan which offers the client the highest degree of freedom in choosing a health care provider is a:
health maintenance organization (HMO).
traditional indemnity plan. preferred provider organization (PPO). managed indemnity plan.
traditional indemnity plan.
One factor that increases the client’s participation in rehabilitation is:
the physician
’
s orders.
financial constraints.
the employer
’
s policies.
family-centered interventions.
family-centered interventions.
One factor that increases the client’s participation in rehabilitation is:
the physician
’
s orders.
financial constraints.
the employer
’
s policies.
family-centered interventions.
family-centered interventions
Which of the following is an accurate statement describing advance directives?
The patient
’
s durable power of attorney is included in the directive.
The patient is given an opportunity to direct his/her own care.
The patient
’
s signature is required as a condition of care.
A lawyer must execute the patient
’
s directive.
The patient is given an opportunity to direct his/her own care.
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The main purpose of client involvement in developing a rehabilitation plan is to:
meet regulatory requirements.
organize the delivery of services and control costs.
improve precision in achievement of goals.
set long-term goals.
improve precision in achievement of goals.
The assessment of variances for each case type and acting immediately to control for these variances are ways in which case managers impact:
usual, customary, and reasonable (UCR) rates.
provider-client communication.
the cost of care.
the standardization of case management practice.
the cost of care
Which member of the multidisciplinary team is the primary provider of medical care services?
Occupational therapist.
Physician.
Nurse.
Case manager.
Physician
In working with diverse populations, case managers should:
understand the client's cultural perspective. ignore differences in order to make the client feel at ease. mainstream the client through education as soon as possible. emulate the cultural differences themselves.
understand the client’s cultural perspective.
All definitions of case management include responsibility for:
coordination of services.
improved access to services.
decreasing costs.
discharge planning.
coordination of services
For case managers participating in an acute care setting, critical pathways provide:
care at the family
’
s request.
care per the insurance carrier.
care per doctor
’
s orders.
standardized patient care techniques.
standardized patient care techniques.
Capitation is a method of:
risk sharing.
fee sharing.
point-of-service.
fee-for-service.
risk sharing
Two essential components of a risk management program are:
loss control and loss prevention.
fall prevention and fall preparedness.
risk identification and compliance.
application of techniques and controls.
loss control and loss prevention.
Preferred Provider Organizations (PPOs) are formed to:
offer Medicare clients a wider range of services.
contract with providers for reimbursement discounts.
eliminate the need for precertification of services.
avoid the need for accreditation by the Utilization Review Accreditation Commission (URAC).
contract with providers for reimbursement discounts.
An important criteria for all powers of attorney is that the:
person designated to receive the power of attorney must be a lawyer.
power of attorney, document, or process requires a court order and a physician
’
s examination.
signer has the right to terminate the power of attorney.
person designated in the power of attorney must reside in the same state as the signer.
signer has the right to terminate the power of attorney.
In writing a case management report, the information must:
be balanced to present an accurate picture.
include subjective assumptions.
document all work done in detail.
use conversational vernacular.
be balanced to present an accurate picture.
Which tool is commonly used to assess the diagnosis of depression in clients with chronic illness?
Short Form Health Survey (SF-12)
Depression Control Test (DCT)
Patient Health Questionnaire (PHQ-9)
Patient Activation Measure (PAM)
Patient Health Questionnaire (PHQ-9)
Root Cause Analysis (RCA) is a component of a(n):
utilization review.
critical pathway.
outcome measurement.
sentinel event assessment.
sentinel event assessment.
An active process in which individuals take responsibility for gathering information about themselves, occupations, and the labor market is:
work adjustment.
situational assessment.
job analysis.
career planning.
career planning.
Advocating for early referral to case management services:
enhances the client
’
s access to appropriate cost-effective services.
eliminates risk behaviors affecting wellness outcomes.
decreases the use of multiple resources.
facilitates provider control of treatment modalities.
enhances the client’s access to appropriate cost-effective services.
Federal law requires mandatory disclosure of:
human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) status.
drug or alcohol abuse.
mental health/psychiatric care.
child abuse.
Child abuse
Use of a family member as the primary caregiver for an individual with a chronic illness may result in:
social isolation for the caregiver.
decreased stressors for the family.
consistent involvement of all family members.
increased social support for the family.
social isolation for the caregiver.
Case managers who carry only a specific type of caseload are referred to as:
specialists.
generalists.
brokers.
experts.
specialists
When the case manager provides a concurrent review to a third party payer, the review should be based on:
established criteria.
the assigned diagnostic related groups (DRGs).
the managed care contract.
the length of stay.
established criteria.
In psychiatric and chemical dependency case management, the client’s diagnosis may be derived from the:
Diagnostic and Statistical Manual of Mental Disorders
’
multi-axial approach.
Monthly case management updates.
International Classifications of Diseases
’
coding system.
Functional Impairment Measurement.
Diagnostic and Statistical Manual of Mental Disorders’ multi-axial approach.
A common category of outcome indicators is:
satisfaction.
social.
family.
rehabilitation.
satisfaction
A cultural blind spot is:
the inability to recognize differences in values and beliefs of others.
an area in one language that cannot be expressed well when translated into another language.
the belief that some populations are inherently superior or inferior to others.
the belief that one
’
s own culture is the most valid.
an area in one language that cannot be expressed well when translated into another language.
According to the Americans with Disabilities Act (ADA), an “otherwise qualified” person is one who is:
perceived as having an impairment.
trained to perform highly skilled functions.
capable of performing essential job functions with or without accommodations.
capable of performing marginal job functions with accommodations.
capable of performing essential job functions with or without accommodations.
During the vocational assessment interview, the rehabilitation counselor should:
listen intently to the client
’
s response.
interpret the client
’
s feelings.
allow the client to guide the interview.
ask close-ended questions.
listen intently to the client’s response.
A case manager providing crisis intervention to a client would:
refrain from attempting to influence the client.
sharply delineate the problem by focusing on the most pressing aspect.
give the client a number of options.
get the client to talk about their childhood experiences.
sharply delineate the problem by focusing on the most pressing aspect.
Eligibility for federally-funded health insurance under Medicare includes:
low income and limited assets.
retirement at age 60.
recipients of Social Security Disability Insurance (SSDI) benefits for two years.
children between ages 18 and 21.
recipients of Social Security Disability Insurance (SSDI) benefits for two years.
In conducting an initial interview, the case manager should remember that the foundation of effective communication lies in:
reflective listening.
encouraging two-way conversations (e.g. dialogues).
asking questions.
focusing on feelings.
reflective listening.
Documenting cost savings from case management interventions may be accomplished by:
completing a cost-benefit analysis.
obtaining family input.
preparing monthly status reports.
participating in a discussion with the referral source.
completing a cost-benefit analysis.
Ergonomics has been defined as the scientific study of how a workplace and the equipment used can best be designed for comfort, efficiency, safety, and:
productivity.
sustainability.
scalability.
risk management.
productivity
Research indicates that the best treatment for depression is a combination of:
short term disability leave and psychotherapy.
social service consult and medication.
psychotropic medication and psychotherapy.
medication and short term disability leave.
psychotropic medication and psychotherapy.
The most common method of assessing the effectiveness of case management is:
length of recovery.
savings reports.
client/employer satisfaction.
decreased litigation costs.
savings reports
The doctrine of informed consent:
supports that the patient has a right to determine what shall be done with his/her own body
ensures adequate disclosure of patient information.
protects the healthcare provider while administering the appropriate treatment.
protects the healthcare provider from malpractice.
supports that the patient has a right to determine what shall be done with his/her own body
The grief reaction and psychological exhaustion experienced by the health care professional that occurs during helping interactions is called:
empathy fatigue.
validation.
secondary trauma stress.
post-traumatic stress disorder.
empathy fatigue
Upon completion of the initial evaluation with the injured worker, the case manager proceeds to:
contact the spouse or significant other of the individual.
authorize medical services on the individual
’
s behalf.
develop a rehabilitation plan based upon the needs of the individual.
initiate retraining services.
develop a rehabilitation plan based upon the needs of the individual.
One of the components of disease management is:
databases are used to direct medical treatment.
the Orem model is used to identify chronic illness.
identification of rates of complication.
population identification processes.
population identification processes.
Cultural competence is the process by which a case manager:
understands all major cultural groups and their family systems
immerses oneself with the language and beliefs of the client.
conducts a self-examination of his/her own prejudices and biases toward other cultures.
strives to achieve the ability to effectively work within the cultural context of the client.
strives to achieve the ability to effectively work within the cultural context of the client.
The first client contact affords an important opportunity for the case manager to:
introduce vocational rehabilitation services.
begin building rapport with the client.
give approval for medical services.
confront the client.
begin building rapport with the client.
A proactive trigger for early case management case selection is:
discharge planning.
health insurance access.
A proactive trigger for early case management case selection is:
discharge planning. health insurance access. diagnosis. hospital readmissions. . hospital readmissions.
Diagnosis
The medical home model is a:
case management approach to improving access to care.
source of primary health care.
method for improving adherence to physician orders.
multi-disciplinary treatment plan in the home setting.
source of primary health care.
Case management organizations are frequently challenged to manage caseloads for effective, quality practice. Which of the following is a major consideration?
Client cooperation.
Nurse to physician ratio.
The case management model.
Case management certification.
The case management model.
An element of legal consent is:
confidentiality.
consideration.
capacity.
coercion.
capacity
Which of the following case management interventions may result in hard cost savings?
Investigation of benefit coverage.
Education on treatment side effects.
Facilitation of medication refills.
Negotiation on equipment purchases.
Negotiation on equipment purchases
When speaking with a client’s family, the case manager will:
assess relationships and roles.
express sympathy for the client.
limit discussion to the needs of the client.
identify potential conflicts among the health care team.
assess relationships and roles.
Which service is classified as a post-acute level of care?
Telementary care.
Inpatient medical care.
Hospice care.
Emergency room care.
Hospice care
What is the best method of documentation to ensure the safety of the client, maximize communication, and improve care?
Narrative progress notes.
SOAP charting.
Multidisciplinary care plans.
Electronic health record.
Multidisciplinary care plans.
The act of giving people the control, accountability, and freedom to act on what they know is:
transformation.
autonomy.
empowerment.
collaboration.
empowerment
To receive Social Security disability benefits, one criterion is that the disability:
is incurred eight or more years after the death of a fully-insured spouse.
is expected to last, or has lasted, at least one year.
prevents return to employment of choice.
remains unclassified by a physician.
is expected to last, or has lasted, at least one year.
Health literacy is defined as:
the ability to read health care instructions.
the skills necessary to understand health care related documentation.
the capacity to obtain, process, and understand basic health information.
an individual
’
s knowledge of their health conditions.
the capacity to obtain, process, and understand basic health information.
An example of a reasonable accommodation is:
providing a medical examination for the individual with a disability so that the employer will know what environmental changes are needed.
requesting that the individual with the disability obtain a physician
’
s medical document stating the accommodation needed.
modifying existing facilities to be readily accessible to an individual with a disability
assigning only 25% work hours to the individual with the disability.
modifying existing facilities to be readily accessible to an individual with a disability
To be eligible for Supplemental Security Income (SSI), a client must be:
able to demonstrate financial need.
deemed to have a permanent disability.
over age 65.
legally blind.
able to demonstrate financial need.
Work hardening following an on-the-job injury consists of:
a test performed by the treating physician to determine physical strengths.
the final stage of physical therapy in preparation for a return to work.
an exercise program offered by the employer to prevent re-injury.
a re-training program offered by state and local agencies.
the final stage of physical therapy in preparation for a return to work.
Disorientation in an elderly client without obvious organic cause could be considered a symptom of:
normal aging.
change of environment.
overmedication.
malnutrition.
overmedication
An example of an operational variance is:
a health care provider
’
s practice pattern.
the breakdown of a piece of equipment.
a patient refusal to allow a procedure.
a complication of the patient
’
s medical condition.
the breakdown of a piece of equipment.
